Health risk appraisal for older people 5: self-efficacy in patient–doctor interactions

Abstract

Objective: Enhancing self-efficacy is central to programmes promoting self-care and self-management. However, little is known about older people's self-efficacy in doctorpatient interactions. This paper investigates lifestyle, medical and demographic factors associated with self-efficacy in doctor-patient interactions in older people in general practice. Methods: A cross-sectional analysis of data from a randomised controlled trial of older people was conducted in a health risk appraisal study in London. Self-efficacy was measured using the Perceived Efficacy in Patient-Physician Interactions Questionnaire. Results: Older people with higher self-efficacy were significantly more likely to report having had recent preventive care measures such as recent blood pressure measurement and influenza immunisation. Women were less likely to have higher self-efficacy than men. Older people were significantly less likely to have high self-efficacy if they reported having poor memory, low mood, limited activities due to fear of falling, basic education, difficulties with at least one activity of daily living, reduced physical activity, living alone, or risk of social isolation. Conclusion: A third of people had low self-efficacy in doctor-patient interactions. They appear to be a vulnerable group. Low self-efficacy in interactions with doctors may be a symptom or a characteristic of older people who experience social isolation and depression. Policies that depend on enhancing self-care and self-management need to consider the large number of older people with low self-efficacy in using medical services, and understanding characteristics in older people associated with lower confidence in doctorpatient interactions may be useful in clinical practice and research.

“I'm Not Just a Heart, I'm a Whole Person Here”: A Qualitative Study to Improve Sexual Outcomes in Women With Myocardial Infarction

“…Patient self‐efficacy may also influence the patient–physician relationship. 38 Development of an effective intervention might include brief assessment of patient self‐efficacy and coping style early in the course of MI care and use this information to personalize care for improvement of sexual and other outcomes. An effective intervention to improve sexual outcomes in women after an MI should be informed by additional research to gain cardiologists’ input, leverage advances in health information technology that can be used for real‐time, personalized decision making and counseling support, fit efficiently into healthcare work flows, extend to other primary care providers, and be easily updated to accommodate expected advances in knowledge about treatment for female sexual dysfunction.…”

Access to primary care for socioeconomically disadvantaged older people in rural areas: a realist review

“…A socioeconomically disadvantaged older person in a rural area is more likely to seek help from primary care if they feel a sense of belonging to a practice 33 35 37 67 which they are able to get to easily, 32 56 64 65 69 believe it will be of help 32 35 66 and are empowered. 33 63 68 These mechanisms are influenced by experience of healthcare, 35 67 educational status, 64 65 personal resources such as self-efficacy 68 and transport. 69 …”

Health Risk Appraisals With Aging Adults: An Integrative Review

“…The HRA-O was an update and adaptation of the HRA-E by European researchers and contained seven sections to collect data. Twenty-two of the articles reported results related to use of the HRA-O including results from initial development and testing, use in intervention trials, and secondary analysis of data generated by the HRA-O (Blozik et al, 2009; Carmaciu et al, 2007; Clough-Gorr et al, 2008; Dapp et al, 2012; Dapp et al, 2011; Iliffe et al, 2009; Iliffe, Kharicha, Harari, Swift, Gillmann, et al, 2005; Iliffe et al, 2007; Iliffe et al, 2013; Iliffe, Kharicha, et al, 2010; Iliffe, Kharicha, Harari, Swift, & Stuck, 2005; Iliffe, Swift, et al, 2010; Kharicha et al, 2007; Lubben et al, 2006; Manthorpe et al, 2010; Raymond et al, 2011, 2012; Stuck et al, 2002; Stuck et al, 2007a, 2007b; Stuck et al, 2015).…”

“…Other. Other reported uses of HRAs included (a) documentation of the transition from robust to frail/disabled (Dapp et al, 2012); (b) a comparison of lifestyle behaviors of well elderly to university students (Bechtel & Franklin, 1993); (c) investigation of lifestyle, medical, and demographic factors associated with self-efficacy in doctor-patient interactions (Raymond et al, 2011); and (d) determination of whether the use of complementary and alternative therapies (CAM) such as acupuncture, herbs, imagery, massage, and naturopathy led to changes in health status (Astin et al, 2000).…”